Occupationally induced airways obstruction.
Garshick-E; Schenker-MB; Dosman-JA
Med Clin North Am 1996 Jul; 80(4):851-878
An overview of occupations most at risk for the development of airflow obstruction and chronic bronchitis as a result of workplace exposure and the agents responsible was presented. Occupational respiratory hazards were identified by case reports or epidemiological methods. Exposure to coal dust resulted in chronic bronchitis and chronic airflow obstruction unrelated to simple coal workers' pneumoconiosis or to progressive massive fibrosis. Lifetime exposure to respirable coal dust was a significant predictor of reduced forced expiratory volume (FEV) after adjusting for cigarette smoking. Autopsies revealed an excess of emphysema in coal and gold miners compared with control workers. Gold miners experienced more bronchitis than controls and decreased FEV related to dust exposure. Workers exposed to dust and fumes from zinc, copper, and nickel mining showed more bronchitis symptoms than controls. Asbestos workers with heavy dust exposure had reduced lung airflow. Coke industry workers had an excess of bronchitis. Grain elevator workers developed symptoms of cough and sputum production soon after hire. Chronic bronchitis was present in 3.5% of nonsmoking controls, compared with 16.5% of nonsmoking grain workers. Years of work at grain elevators predicted a lower FEV with an additive effect of smoking. Inhalation of cotton, flax, or hemp dust was associated with byssinosis and chronic bronchitis. Swine containment workers showed chronic cough and bronchitis related to endotoxin levels, not dust. The authors conclude that occupational exposure to a variety of organic and inorganic dusts, gases, and fumes is associated with chronic bronchitis and decrements in FEV, and the effects of smoking are usually additive.
Occupational-hazards; Occupational-exposure; Humans; Lung-disorders; Bronchial-asthma; Airway-resistance; Mine-workers; Lung-function; Grain-elevator-workers; Dust-exposure; Cigarette-smoking
Medical Clinics of North America
University of California - Davis